Etiological and Histopathological Spectrum of Granulomatous Skin Diseases: A Retrospective Descriptive Study from a Tertiary Care Hospital in Pakistan
DOI:
https://doi.org/10.66344/jpad.v36i2.3198Keywords:
etiological spectrum, histopathology, granulomatous diseasesAbstract
Background Granulomatous skin diseases include diverse groups of disorders, and they pose a diagnostic difficulty because of their overlapping clinical features. Although they have a wide etiological spectrum, from infectious diseases like tuberculosis to noninfectious diseases like sarcoidosis. Due to high prevalence of these infections in Pakistan, accurate histopathological evaluation is needed to guide proper treatment.
Objective To find out the etiological spectrum, prevalence, and histopathological patterns of granulomatous diseases and to evaluate their regional distribution and clinical significance.
Methods This retrospective descriptive cross-sectional study was carried out between January 2021 and December 2023 at Khyber Teaching Hospital, Peshawar. Among them, 60 cases (16.7%) with confirmed histopathological granulomatous inflammation were included. Immunohistochemistry, and special stains were used to confirm the specific aetiology where needed. Data were analyzed using SPSS 22.0.
Results Infectious etiologies were most common, led by cutaneous tuberculosis (38.4%, n=23) followed by cutaneous leishmaniasis (33.4%; n=20), leprosy (10%; n=6) and syphilis (5%; n=3). Among the noninfectious cases, sarcoidosis was on top (8.3%; n=5) followed by foreign body granuloma (5%; n=3). Lupus vulgaris was the most predominant subtype of cutaneous tuberculosis (65.2%; n=15) followed by scrofuloderma (26%; n=6) and Tuberculosis verrucosa cutis (8.69%; n=2). Lepromatous Leprosy was the most frequently observed form of leprosy.
Conclusion Granulomatous diseases represent a significant health burden in Pakistan, particularly cutaneous tuberculosis and cutaneous leishmaniasis which account for over 70% of cases. Early skin biopsies with a clinicopathological correlation and aided by special stains and immunohistochemistry where needed is essential for accurate diagnosis, proper treatment, and improved patient outcome.
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